caa a22 4500 445329386 CHVBK 20180317142732.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s10143-010-0297-y doi (NATIONALLICENCE)springer-10.1007/s10143-010-0297-y Reversible occlusion (on-off) valves in shunted tumor patients [Elektronische Daten] [Daniel Hertle, Johannes Tilgner, Karin Fruh, Timo Keinert, Anna Hagenston, Andreas Unterberg, Alfred Aschoff] The first commercially produced adjustable valve for shunted hydrocephalus patients was introduced by H. Portnoy and R. Schulte in 1973. This valve is still in use and known as reversible occlusion or on-off valve. The reversible occlusion valve is mainly used in conjunction with an existing shunt in patients receiving intraventricular cytostatic therapy. The valve has a simple mechanical lock that is closed by external pressure application with a single finger. The study method is a retrospective clinical series of 15 patients undergoing a total of 16 valve implantations between 2003 and 2010 was carried out, and the valve was tested in vitro. We report a high incidence of accidental occlusions leading to a loss of consciousness in five patients (33.3%). We furthermore demonstrate in vitro that accidental occlusions can occur. The reversible occlusion valve is needed in shunted tumor patients receiving intrathecal administration of cytostatica. The mechanism works as long as no external pressure compresses the valve. However, head positions pose significant risks for unintentional occlusions. We stress the importance of: (1) a position near the midline avoiding the retroauricular or occipital regions, (2) a handling training for nurses and doctors, (3) instruction of patients and relatives, and (4) removal of the device after intrathecal cytostatic treatment. Springer-Verlag, 2010 On-off valve nationallicence Reversible occlusion valve nationallicence Hydrocephalus nationallicence Shunt nationallicence Intrathecal drug administration nationallicence Hertle Daniel Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut Tilgner Johannes Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut Fruh Karin Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut Keinert Timo Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut Hagenston Anna Department of Neurobiology, Interdisciplinary Center for Neurosciences (IZN), and Exzellenzcluster CellNetworks, University of Heidelberg, Heidelberg, Germany aut Unterberg Andreas Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut Aschoff Alfred Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut Neurosurgical Review Springer-Verlag 34/2(2011-04-01), 235-242 0344-5607 34:2<235 2011 34 10143 https://doi.org/10.1007/s10143-010-0297-y text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10143-010-0297-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hertle Daniel Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut NATIONALLICENCE 700 1- Tilgner Johannes Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut NATIONALLICENCE 700 1- Fruh Karin Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut NATIONALLICENCE 700 1- Keinert Timo Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut NATIONALLICENCE 700 1- Hagenston Anna Department of Neurobiology, Interdisciplinary Center for Neurosciences (IZN), and Exzellenzcluster CellNetworks, University of Heidelberg, Heidelberg, Germany aut NATIONALLICENCE 700 1- Unterberg Andreas Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut NATIONALLICENCE 700 1- Aschoff Alfred Department of Neurosurgery, University of Heidelberg, INF 400, D-69120, Heidelberg, Germany aut NATIONALLICENCE 773 0- Neurosurgical Review Springer-Verlag 34/2(2011-04-01), 235-242 0344-5607 34:2<235 2011 34 10143 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer